Arthroplasty (Artificial Disc Replacement)

Artificial disc replacement is a minimally invasive surgical procedure which involves removal and replacement of damaged intervertebral discs with artificial discs to restore motion and allow for normal functioning of the cervical and lumbar spine. Intervertebral discs are responsible for shock absorption between the vertebrae and play an important role in maintaining spinal alignment.

Degeneration of intervertebral discs can cause stress on the facet joints, compression of spinal nerve roots and leads to loss of alignment across any part of the spine. It most commonly occurs in the cervical (neck) and lumbar (lower back) regions of the spine. Artificial disc replacement serves as an alternative treatment option for fusion to treat lower back pain or neck pain, due to its property of preserving normal motion.

Indications for artificial disc replacement

Although artificial disc replacement may not be an appropriate treatment for all patients with back or neck pain, some characteristic features include:

• Discogenic lumbar/cervical pain
• Back pain caused by 1-2 intervertebral discs in the lumbar region
• Patients with no significant facet joint disease
• Patients with no bony compression on spinal nerves
• Patients with no spinal deformities such as scoliosis
• Appropriate body size and body weight
• Underlying degenerative disc disease unresponsive to conservative treatment.

The above mentioned are some characteristic features to be considered for artificial disc replacement. However, adequate diagnostic tests including MRI, discography, CT-scans and X-rays must be taken to determine if you are a good candidate for artificial disc replacement.

Procedure of artificial disc replacement

Artificial disc replacement procedure is generally performed on an outpatient basis under general anesthesia. Your surgeon approaches your lumbar or cervical regions depending on the site of replacement through a small incision. The damaged disc is exposed and removed followed by preparation of disc space for disc replacement. Then, a disc replacement device is inserted into the disc space under fluoroscopic and X-ray guidance. Appropriate disc design and material is selected and carefully placed in the disc space. Finally, the incision is closed with sutures.

Recovery

Patients are usually discharged on the same day, however some patients may require a short hospital stay of 1-3 days. The length of the stay may depend on the level of pain control and restoration of function. You may be encouraged to perform basic exercises such as walking and stretching through the initial weeks of surgery for faster recovery. Complete recovery may take about six weeks.